European Radiology

, Volume 28, Issue 10, pp 4362–4369 | Cite as

Early osteosclerotic changes predict chemotherapy response in non-small-cell lung cancer patients with bone metastases

  • Dailin Rong
  • Yize Mao
  • Qiuxia Yang
  • Shuhang Xu
  • Qianqian Zhao
  • Rong ZhangEmail author
Computed Tomography



To explore the relationship between osteosclerotic changes and chemotherapy response in non-small-cell lung cancer (NSCLC) patients with bone metastases (BM).


Fifty-two NSCLC patients with BM were enrolled from 1 January 2010–31 June 2015 and divided into two groups based on their CT features: an osteosclerotic change (OC) group and a no-osteosclerotic change (NOC) group. The disease control rate (DCR) was evaluated, and progression-free survival (PFS) was analysed using Kaplan-Meier curves. Univariate and multivariate Cox regression analyses were performed to analyse the factors that could affect PFS.


Osteosclerotic changes were observed in 35/52 patients. The median interval when osteosclerotic changes occurred was 2 months (range 1–3 months) after chemotherapy. The OC group had a significantly higher 3-month DCR than the NOC group (p < 0.001). The OC group had a higher 1-year PFS rate than the NOC group (1-year PFS: 74.9% vs. 30.2%, p < 0.001). Univariate Cox regression analysis indicated that pathological subtype (HR = 4.419; 95% CI = 1.635–11.941, p = 0.003) and osteosclerotic changes (HR = 0.199; 95% CI = 0.083–0.477, p < 0.001) were significant predictors of PFS.


Early osteosclerotic changes predict chemotherapy response in NSCLC patients with BM.

Key Points

Osteosclerotic changes were prevalent CT features after chemotherapy in NSCLC patients.

Osteosclerotic changes were positively related to increased 3-month DCR.

Osteosclerotic changes were positively related to increased 1-year PFS rate.


Osteosclerotic changes Non-small-cell lung cancer Bone metastases Computed tomography Progression-free survival 



Bone metastases


Computed tomography


Disease control rate


Without osteosclerotic changes


Non-small-cell lung cancer


Osteosclerotic changes


Progression-free survival



We thank the native English-speaking scientists of American Journal Experts for editing our manuscript.


The authors state that this work has not received any funding.

Compliance with ethical standards


The scientific guarantor of this publication is Rong Zhang, Sun Yat-Sen University Cancer Center

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was not required for this study because this was a retrospective study

Ethical approval

Institutional Review Board approval was obtained.


• retrospective

• observational

• performed at one institution

Supplementary material

330_2017_5253_MOESM1_ESM.docx (2.4 mb)
ESM 1 (DOCX 2481 kb)


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Copyright information

© European Society of Radiology 2017

Authors and Affiliations

  1. 1.State Key Laboratory of Oncology in Southern ChinaGuangzhouPeople’s Republic of China
  2. 2.Department of RadiologySun Yat-Sen University Cancer CenterGuangzhouPeople’s Republic of China
  3. 3.Department of UltrasoundThe Third Affiliated Hospital of Sun Yat-Sen UniversityGuangzhouPeople’s Republic of China

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